APOCYNUM CANNABINUM
   The root of Apocynum cannabinum, Linné (Nat. Ord. Apocynaceae) gathered in autumn after the leaves and fruit have matured. Grows throughout the United States. Dose, 1 to 20 grains. Common Names: Bitter Root, Canadian Hemp, and improperly, Indian Hemp. Principal Constituents.—A resinous principle—apocynin, and a yellow glucoside, apocynein; and apocynamarin, or cynotoxin, or cymarin, all of which resemble digitalis glucosides in action. Preparations.-1. Specific Medicine Apocynum. Dose, 1/4 to 20 drops. Usual form of administration: Rx Specific Medicine Apocynum, 10 drops to 1 fluidrachm; Water, four ounces; Mix. Sig. One teaspoonful every 1 to 3 hours. 2. Decoctum Apocyni, Decoction of Apocynum (root 1 ounce to Water, 16 ounces). Dose, 1 to 2 fluidrachms. Specific Indications.—Watery infiltration of cellular tissue—edema— with weak circulation and general debility; skin blanched, full, smooth, and easily indented; puffiness under the eyes; eyelids wrinkled, as if parts had been recently swollen; feet full and edematous, pitting upon pressure; constipation, with edema; urine scanty and circulation sluggish; boggy, watery uterus; full relaxed uterus with watery discharge; profuse menorrhagia, too often and too long continued; passive hemorrhages, small in amount and associated with pedal edema; mitral and tricuspid regurgitation, with rapid and weak heart action, low arterial tension, difficult breathing, cough, and tendency to cyanosis. Action.—Apocynum acts powerfully upon the heart, slowing its action and raising arterial tension. The cardiac muscle appears to be directly stimulated by it as are probably the arterial coats. Contraction of the renal arteries also takes place, so that while less blood passes at a time through the kidneys, the act of filtration is more perfect and marked diuresis results. Though long known that diuresis was one of its most prominent results, the knowledge that this is due to the better cardiac pressure and arterial tonus, rather than to the increased intrinsic secreting power of the renal glomeruli, is the result of pharmacologic investigation in recent years, particularly the work of Horatio C. Wood, Jr. The general effects upon man of full doses of apocynum are nausea, and sometimes vomiting and purging, succeeded by copious sweating. The pulse is then depressed, and in some a disposition to drowsiness is observed until relieved by vomiting. The powdered drug causes sneezing. The small doses employed in Eclectic therapeutics seldom occasion any of the above-named symptoms save that of severe watery purging, which may occur suddenly, when the drug has been administered persistently for several weeks. Therapy.—No remedy in the Eclectic materia medica acts with greater certainty than does apocynum. In former times it was employed in heroic doses chiefly for its hydragogue cathartic and diuretic effects. Early in the last century it was employed by the botanic practitioners for the relief of dropsy. Later the Eclectic school developed its specific uses in dropsy and affections of the heart and circulation. Like many similar drugs, the powder was employed as a sternutatory in the days when it was believed that such effects as the increasing of the nasal discharges was the best way to relieve headaches and certain catarrhal affections. Again, it was recommended in diaphoretic doses, for the relief of intermittent and remittent fevers, and in pneumonic involvements, conditions in which it is now seldom or never thought of. It is rarely employed nowadays as a cathartic, and then only in dropsical conditions, as other hydragogues have been similarly used. Such is the use of it advocated by the authors of the regular school of medicine, by those who use it at all; and from such a use arises the criticisms frequently indulged in in condemnation of the drug. Eclectics do not use it in this manner. Specific medication has established that this action is not necessary, for when specifically indicated it promptly removes effusions without resorting to cathartic doses. Consequently it finds little use as a cathartic, except very rarely as recommended by Goss, for the removal of ascarides. To use apocynum intelligently and successfully, the prescriber must recognize, first, that debility is the condition in which it exerts its specific and beneficial effects—debility of the heart and circulatory apparatus, of the kidneys, of the capillaries of the skin particularly. In such a state it will prove a remedy; under opposite conditions it is likely to prove an aggravation. The patient with a strong, rope-like, hard, and quick pulse is not the patient for apocynum. On the other hand, the feeble pulse, soft and of little force, indicates its selection as the remedial agent. The atonic state which readily permits of exudation from the blood vessels is the ideal condition which we seek to remedy with apocynum. It is a vascular stimulant. Such results one would not expect to obtain if there were circulatory obstruction or active fever. The only apparent exception, in which it is adapted to active conditions, is that reported by Webster of its efficacy in active inflammation of the upper pharyngeal and post-nasal tract, where, he declares, it rivals phytolacca in its results. One can not expect apocynum to reconstruct wornout tissues or to restore damaged vascular valves. We must not hope to work miracles with it where there are such structural lesions as incurable or malignant organic diseases of the heart, liver, or kidneys. Yet in these conditions, when debility and subcutaneous, watery exudation are strong factors, it alone is a powerful remedy to relieve urgent symptoms and to put into action that portion of sound tissue that remains. The most we can hope for is an amelioration of the symptoms, and a notable decrease of the watery accumulation may be looked for. Under these circumstances we have removed enormous dropsical swellings with it, giving quick relief from dyspnea and¹

EUPHORBIA COROLLATA
   The bark of the root of Euphorbia corollata, Linné (Nat. Ord. Euphorbiaceae). Dry fields and woods of Canada and the United States. Common Names: Large Flowering Spurge, Blooming Spurge, Milk Purslane, Snake Milk. Principal Constituents.—Resin, caoutchouc, and probably euphorbon. Preparation.—Specific Medicine Euphorbia. Dose, 1/10 to 10 drops. Specific Indications.—Persistent gastric irritation; irritative diarrhea of catarrhal discharges, with debility; long-pointed tongue, with prominent papillae; uneasy sensation in the stomach; cholera infantum, with hot, tumid abdomen and constant desire to defecate, the stools being greenish and irritating; irritation of the respiratory tract, especially the glottis, with persistent cough and tough and tenacious secretion. Action and Therapy.—In full doses euphorbia is a comparatively mild emetic; in overdoses it causes drastic emeto-catharsis. It was formerly used to fulfill the purposes of an emetic and purgative in dropsical conditions. It is now used chiefly in small doses for irritation of the gastrointestinal and respiratory tracts. It often relieves diarrhea and dysentery, with full and tenesmic passages. It is especially useful in cholera infantum, with hot, tender abdomen and constant desire to go to stool, the discharges being greenish and irritating. Euphorbia is a good gastrointestinal sedative and tonic, and is most effective when the tongue is red, long and pointed, and there is persistent vomiting. In moderate doses it may be used in obstinate constipation, with evidence of gastric irritation. Euphorbia is contraindicated by active inflammation. Bowles (Eclectic Medical Journal, 1921, page 459) praises Euphorbia as an excellent sedative for persistent, irritative cough following influenza, and that due to chronic catarrhal inflammation of the larynx and pharynx. The glottis seems especially irritable and the cough is exasperating—worse from riding or walking in the cold air, or is aggravated by exertion after a full meal. There is but little secretion, and that is tough, tenacious, and glutinous, and requires persistent hawking to aid in its expectoration. One or two drops may be taken upon the tongue and slowly swallowed; or 40 drops of Specific Medicine Euphorbia may be added to 4 ounces of water, and of this a teaspoonful may be taken every 2 hours. Bowles also used it, with phytolacca and phosphate of hydrastin, to reduce enlarged tonsils following tonsillitis. The American species of Euphorbia furnish a rich field for restudy. Formerly some of them were quiet extensively used as medicines, but seem to have been crowded out by similarly-acting foreign drugs. The chief indications for Euphorbia are: profuse mucous discharges, whether from the pulmonic, gastro-intestinal, or urino-genital mucosa; or the tough, glutinous tracheo-broncho-pulmonic secretions, with irritation.¹

IRIS^IRIS
   The rhizome and roots of Iris versicolor, Linné (Nat. Ord. Iridaceae). Common in wet places in the United States. Dose, 5 to 20 grains. Common Names: Blue Flag, Larger Blue Flag, Fleur de Luce. Principal Constituents.—Volatile oil, a whitish-yellow resin, a trace of an alkaloid, and a comphoraceous body. Preparation.—Specific Medicine Iris. Dose, 1 to 20 drops. Specific Indications.—Enlarged, soft and yielding lymphatic enlargements; thyroid fullness; splenic fullness; chronic hepatic disorders, with sharp, cutting pain, aggravated by movement; claycolored feces, with jaundice; nausea and vomiting of sour liquids, or regurgitation of food, especially after eating fats or rich pastry, or ice cream; watery, burning feces; rough, greasy skin, with disorders of the sebaceous follicles; abnormal dermal pigmentation. Action.—Iris stimulates the glands of the body to increased activity and impresses the nervous system. In large doses it is emeto-cathartic, acting violently, the vomitus being acid and the catharsis watery and persistent and accompanied by colic and rectal heat. Iris increases the hepatic and pancreatic secretions, as well as those of the intestines. Iris also salivates, but without injury to the gums and teeth. Salivation from vegetable sialagogues may be differentiated from that caused by mercury by the absence of mercurial fetor and lack of sponginess of the gums or loosening of the teeth. Neuralgic pain is said to be produced by iris when given in large doses; and when even moderately full therapeutic doses are administered it produces a more or less persistent belly-ache and mild catharsis. Iris is capable of causing gastro-enteritis resulting in death. To be effective iris preparations must be made from prime, heavy, resinous root-stocks; when old and light, like tan-bark, iris produces neither physiologic nor therapeutic effects. Therapy.—External. Specific Medicine Iris has been painted upon goitre with good results, though it is effectual in but few instances, and the type is not as yet well defined. It is also advised as an efficient local treatment for psoriasis, chronic itching eczema, various types of tinea, prurigo, and crusta lactea. In all of the preceding disorders the drug should be given internally while being applied externally. Internal. Iris is alterative and cholagogue. It exemplifies as fully as any drug the meaning of the term alterative as used in Eclectic therapy. Perhaps this is best expressed to-day by saying that it corrects perverted metabolism. Iris, in small doses preferably, quietly stimulates the glandular structures of the body, both the glands with outlets and the ductless glands. It promotes waste and excretion, two processes necessary before repair can well take place. In broad terms it is a remedy for “bad blood” and imperfect nutrition. The term “bad blood” or blood dyscrasia has, as a rule, little relation to the blood itself, but pertains chiefly to imperfect lymphatic elimination and faulty retrograde metamorphosis. Iris impresses the thyroid function, is of great value in the adenopathies of syphilis and skin affections, with imperfect functioning of the lymphatic system resulting in enlarged lymph nodes. Hepatic torpor, splenic fullness, and jaundice, with claycolored stools are influenced for good by it, the drug acting quietly as an alterative when given in small and repeated doses. Iris should be used in the various cachexias—lymphatic, scrofulous and syphilitic. It proves more or less useful in some cases of goitre or enlarged thyroid, whether the enlargement be constant, or merely the temporary fullness associated with the menstrual function, normal or abnormal. When it does good it is chiefly in reducing enlargement, and appears to have but little influence upon the tachycardia and other disturbances of hyperthyroidism. As a rule, soft glandular enlargements are best treated with iris, and hard enlargements with phytolacca. However, iris is sometimes surprisingly effective in goitre, while more often it seems to fail completely. The exact type most benefited has never been clearly defined. In order to obtain satisfactory results at all, the use of the drug must be continued over a period of several months. In exophthalmic goitre it may be given early, but without great hope of doing more than to affect the bodily glandular functions, thereby improving the general health of the patient. The same may be said for it in Addison's disease, in which it has sometimes benefited, but has not, of course, cured. Iris is often useful in splenic fullness, and ovarian and uterine turgescence in cachectic individuals. Minute doses of iris relieve gastric irritation, with nausea, vomiting, and gastralgia. In like doses it is sometimes useful in cholera infantum, and in either diarrhea or dysentery, both with large, slimy evacuations, repeated small doses have proved very effectual. Still for all these bowel troubles it is far inferior to ipecac. It is quite certain, however, to relieve sick headache dependent upon indigestion, and bilious headache, with nausea and sour and bitter vomiting, and claycolored stools. In fact one of the most important uses for iris is in that complex condition included in the elastic denomination “biliousness”. For regurgitation of fatty foods or pastries it is especially effective. In hepatic congestion, with constipation, and sharp-cutting pains, increased by motion, iris frequently gives relief. When constipation depends upon hepatic and intestinal torpor and in duodenal catarrh, with jaundice and clay-colored feces, iris should be considered as a possible remedy. Aching pain, with pressure beneath the scapulae, usually dependent upon hepatic wrong, is relieved by 1 to 5 drop doses of specific medicine iris.¹

MATRICARIA
   The dried flower-heads of Matricaria Chamomilla, Linné (Nat. Ord. Compositae). Wastes of Europe, Asia, and Australia. Dose, 1 to 60 grains. Common Names; German Chamomile, Wild Chamomile. Principal Constituents.—A dark-blue, aromatic, volatile oil (Oleum Chamomillae Aethereum) and possibly a crystallizable, bitter, anthemic acid, and a crystalline alkaloid anthemidine. Preparations.—1. Specific Medicine Matricaria. Dose, 1 to 60 drops. 2. Infusum Matricaria, Infusion of Matricaria (1/2 ounce to 16 fluidounces). Dose, 1 to 4 drachms. Specific Indications.—Nervous irritability, with fretfulness, peevishness, impatience, and discontent; morbid sensitiveness to pain and external impressions; sudden fits of temper when menstruating; muscular twitching; fetid, greenish feculent alvine discharges, or when the stools are green and slimy, or of mixed whitish curds and green mucus, associated with flatulence, colic, and excoriation of the anal region; if a child, the head sweats easily and the discomforts of teething, flatulent colic, etc., are transient and intermitting, and the nervousness is relieved by being carried about in the arms. Therapy.—According to dose and manner of use, matricaria is a stimulant diaphoretic and nerve sedative. Its calmative action is so satisfactory that even the skeptic in therapeutics becomes a convert to the fact that there is great therapeutic energy in some simple agents which, by usual tests, fail to show decided so-called physiological action. Matricaria, simple and safe as it is, is remedially potent. Could it more generally have taken the place of “soothing syrups”, so largely destructive to infant life, the history of baby mortality might have been a less appalling story. No child need be laid in its grave because of its administration. Matricaria, better known to some as chamomilla, is pre-eminently a child's remedy, especially for the very young child. It has two wellmarked, specific fields of action—(1) on the nervous system, subduing irritability; and (2) on the gastro-intestinal tract, allaying irritation. Its influence is well seen upon the infant during the period of dentition. In such conditions it is adapted to the restless, peevish, irritable, discontented, and impatient infant, who is only appeased when carried about in order to quiet its nervousness and unrest. The child needs both sympathy and matricaria, both sound measures in infant therapeutics. In such children it may be equally a remedy for constipation or diarrhea. In the former case, there is usually hepatic tenderness. In the latter, the discharges may be variously characterized-watery and greenish, slimy, green and slimy, or yellow and white lumps of undigested curds, giving them the wellknown name of “eggs and greens”. Such stools usually excoriate the child severely, and are accompanied by colicky pain of greater or less severity. The urine is passed with difficulty, and there is more or less bloating of the abdomen. Flatulence is often marked, and the surface is alternately flushed and pale. Under such irritable conditions it proves a useful remedy in infantile dyspepsia, and when teething the child cries out in sleep and there is sometimes a tendency to convulsions. This condition it may ward off by controlling the nervous excitation, but it is of little value after convulsions occur. Sometimes a gently laxative dose of sodium phosphate preceding or accompanying the matricaria will enhance the efficacy of the latter. Matricaria is useful for the swelling of the breasts in the newborn (usually with phytolacca), and in the involuntary passage of urine in the young. For the flatulent colic of early infancy it is one of the safest and most effectual medicines. For this purpose it should not be sweetened. Matricaria is invaluable in some affections of nervous women, a field in which it is too frequently neglected, perhaps not being considered a powerful enough medicine. In woman or child it is a nerve sedative, and adapted to irritation and not to atony. In the latter months of pregnancy it frequently allays false pains, cough, nervous muscular twitching, and other unpleasant nervous phenomena. In amenorrhea and dysmenorrhea, with weighty feeling in the uterus and tympanites, it often relieves, as it does in cases presenting sudden explosions of irascibility, and in those having cramping or labor-like pains and meteorism. The hot infusion is particularly useful in suppressed menstruation from colds, and often controls earache and facial neuralgia from the same cause. The matricaria patient is extremely and morbidly susceptible to pain, is hyperesthetic, and the nervous apprehension is all out of proportion to the actual pain suffered. This remedy should be resorted to when one is tempted to employ opiates and other more powerful pain relievers.¹

PHYTOLACCA
   The recently dried root and fruit of Phytolacca americana, Linné (Nat. Ord. Phytolaccaceae). North America, along roadsides and fences, and in clearings and uncultivated fields; grows also in northern Africa, southern Europe, China, the Azores, and Sandwich Islands. Dose, 1 to 20 grains. Common Names: Poke, Poke-root, Poke Weed, Garget, etc. Principal Constituents.—Root: A remarkably large amount of potassium, a body closely resembling saponin, and the alkaloid phytolaccine. Berries: A purplish-red powder (the coloring body), indifferent phytolaccin, and phytolaccic acid. Preparations.—1. Specific Medicine Phytolacca. (Prepared from the root.) Dose, 1 to 20 drops. (Usual form of administration: Rx Specific Medicine Phytolacca, 10-30 drops; Water, enough to make 4 fluidounce. Mix. Sig.: One teaspoonful every one, two or three hours. 2. Tinctura Phytolaccae Recentium, Green Tincture of Phytolacca. (Fresh, recently dried root, 8 ounces (This should read: Fresh root, 8 ounces [the customary definition of “Green Tincture”]...MM); Alcohol (76 per cent), 16 fluidounces.) Dose, 1 to 30 drops. Specific Indications.—Pallid mucous tissues with ulceration; sore mouth, with small blisters on buccal mucous surfaces and tongue; sore lips, pallid and with separated epidermis; fauces full and mucous surfaces pallid, sometimes livid, with swollen tonsils and whitish or ashen-gray tenacious exudate; aphthae; imperfect glandular secretion; faucial, tonsillar or pharyngeal ulceration; secretions of mouth impart a white glaze over mucous membranes and tongue; white pultaceous sloughs at angles of mouth or lining the cheeks; hard painful glandular enlargements; pallid sore throat with cough and difficult respiration; mastitis; orchitis; parotitis; soreness and swelling of mammary glands; diphtheroidal sore throat; and fatty degeneration . Action.—Physiologically, phytolacca acts upon the skin, the glandular structures, especially those of the mouth, throat, sexual system, and very markedly upon the mammary glands; also upon the fibrous and serous tissues, and mucous membranes of the digestive and urinary tracts. It is principally eliminated by the kidneys. Applied to the skin, either in the form of juice, strong decoction, or poultice of the root, it produces an erythematous, sometimes pustular, eruption. The powdered root when inhaled is very irritating to the respiratory passages, and often produces a severe coryza, with headache and prostration, pain in chest, back, and abdomen, conjunctival injection and ocular irritation, and occasionally causes violent emeto-catharsis. Upon the gastro-intestinal tract doses of from 10 to 30 grains of it act as an emetic and drastic cathartic, producing nausea which comes on slowly, amounting almost to anguish, finally after an hour or so resulting in emesis. It then continues to act upon the bowels, the purging being prolonged for a considerable length of time. It is seldom used for emeto-cathartic purposes, on account of its tardy action, which, when established, continues for some time. It rarely causes cramps or pain. Large doses produce powerful emeto-catharsis, with loss of muscular power -occasionally spasmodic action takes place, and frequently a tingling or prickling sensation over the whole surface. Dimness of vision, diplopia, vertigo, and drowsiness are occasioned by large doses not sufficient to produce death. Phytolacca slows the heart’s action, reduces the force of the pulse, and lessens the respiratory movements. It is a paralyzer of the spinal cord, acting principally on the medulla. In poisoning by this agent tetanic convulsions may ensue. Death results from carbonic acid poisoning, the result of respiratory paralysis. The treatment of poisoning by phytolacca is that of gastro-enteritis. Therapy.-External. A poultice of poke root has given relief to felons and mammary inflammation. If used early resolution may take place; if suppuration occurs it will hasten that process. Locke advised the specific medicine with glycerin (2 fluidrachms to 1 fluidounce) for external use in mammitis. The same preparation occasionally heals sore nipples, and an ointment has been used successfully in scaly forms of eczema, in glandular engorgement, and may give relief in some cases of hemorrhoids, and in goitre. In most instances its local use should be accompanied by its internal exhibition. Internal. Medicines which act directly upon the glandular structures are not numerous. Among those that do so act, none is more direct than phytolacca. Phytolacca belongs to that class of remedies which is denominated alteratives. Whether such terms as the latter are justifiable in the light of present-day progress may be open to question. The experience of many years with phytolacca with success in what has been understood to be alterative effects, is a matter of Eclectic record. That it powerfully impresses the glands of the skin, lymphatic system, buccal, faucial, nasal, and sexual systems, and particularly the tonsils, ovaries, testicles, and mammary glands, we are well satisfied. The periosteal and other fibrous tissues are also acted upon by it, and there is no doubt but that it has more or less influence over the deposition of fats, its favorable action in fatty degeneration of the heart entitling it to consideration. Phytolacca is pre-eminently a remedy for swollen or engorged glands and adenitis. It is of undeniable value in conditions which might be conveniently classed as the dyscrasias-scrofulous, syphilitic, and rheumatic. It is not a direct antisyphilitic in the sense that it will destroy treponema, but for the train of ills due to the ravages of that disease as shown in the glandular and skin involvement it is among the most useful of drugs. When ulcerations result from the same cause it is particularly effective. It has long been used in various mixtures designed as antisyphilitics, which are, of course, but general alteratives. In those vague conditions, with pain and¹